Infant formula and bottle-feeding

What is infant or baby formula?

Most baby formula is made from cow’s milk that has been modified so that it suits your baby’s nutritional needs. But it’s not the same as cow’s milk.

Why babies need formula rather than cow’s milk

All baby formula has added vitamins, minerals and fats that babies need, which they can’t get from straight cow’s milk.

Also, babies can’t digest cow’s milk as completely or easily as breastmilk or formula. The protein level in cow’s milk is too high for babies, so some is taken out for infant formula.

For these reasons, you shouldn’t give cow’s milk to your baby as the main milk drink until your baby is over 12 months old.

Babies under 12 months of age should not have:

normal cow’s milk as a main drink
skim, evaporated, powdered or sweetened condensed milk
dairy alternatives like soy, rice, almond or coconut milk.

For most healthy full-term babies, breastmilk or cow’s milk-based baby formulas are recommended until 12 months of age. If you’re thinking of feeding your baby something other than breastmilk or cow’s milk-based formula, talk to your paediatrician, GP or child and family health nurse first.

Stage 1 and stage 2 formulas

Cow’s milk-based baby formulas for babies up to six months of age are called stage 1 or starter formulas. You can use stage 1 formulas up until your baby is 12 months old.

From six months, you can choose stage 2 or follow-on formula, but you don’t need to change to stage 2. You might see advertisements about the benefits of stage 2 or follow-on baby formulas, but these have no advantages over starter or stage 1 formulas.

Which baby formula is best?

Every baby formula you can buy in Australia meets strict Australian Standards.

Most cow’s milk-based baby formulas are of similar quality and nutritional value and are suitable for most babies.

A brand might be more expensive, but that doesn’t mean it’s necessary for your baby. And a hospital’s use of a particular brand of infant formula doesn’t mean that the brand is the ‘best’.

You can buy baby formula in powder form or ‘ready to drink’ form. Either is fine for your baby, but ‘ready to drink’ is usually more expensive because it’s more convenient.

Baby formula with special additives

Some baby formulas have extra ingredients added to them to make them more like breastmilk. But this doesn’t necessarily mean those ingredients will work in the same way as breastmilk in your baby’s body.

Here are some common extra ingredients added to baby formula, with information about whether they’re likely to do your baby any extra good:

LCPs: these are important for brain and nerve development. But there’s no clear evidence that babies can absorb ingredients like LCPs when they’re added to formula. Formula with added LCPs might be helpful for formula-fed premature babies’ brain development.
Betacarotene: this is a source of vitamin A and anti-oxidants. Most formulas already have added vitamin A and anti-oxidants. There’s no real evidence that betacarotene formulas are better for your baby.
Prebiotics and probiotics: these can help formula-fed babies grow healthy bacteria in their bowels. The bacteria might help your baby have softer poo and less nappy rash. It might also help reduce the chance of gastroenteritis.

Also note that these formulas might be more expensive than other formulas.

Special baby formulas

For babies under 12 months of age, cow’s milk-based baby formula is recommended over formulas made from soybeans, goat’s milk or low-lactose or lactose-free formula.

But babies who can’t have cow’s milk-based formula might need special formula. You should use special baby formulas only under medical supervision.

Soy-based baby formula
Some babies can’t have dairy-based products because of allergies or intolerances. Or you might not want to use regular baby formula because of cultural, religious or other beliefs.

Soy-based formula will give your child all the nutrients she needs. But if you’re thinking of switching to a soy formula, talk to a doctor or dietitian first.

There have been some concerns about the effects of phytoestrogens in soy formula on babies. But soy formulas are considered safe to use if your baby needs one.

Soy-based formulas don’t prevent or reduce the risk of your child developing allergies.

Hydrolysed baby formula
Hydrolysed formula is cow’s milk-based formula in which the milk proteins have been broken down into smaller components. This kind of formula includes partially hydrolysed formula (which is also called hypoallergenic formula) and extensively hydrolysed formula.

If your baby has a diagnosed cow’s milk protein allergy and you aren’t breastfeeding, your doctor might recommend extensively hydrolysed infant formula.

There’s no evidence that giving babies hydrolysed infant formula prevents allergy problems from developing, even if you have a family history of allergies.

Prethickened formula and thickening agents
Prethickened formula is cow’s milk-based formula that has a thickener added. You can also buy thickening agents to add to standard baby formula yourself.

Your doctor might recommend thickeners or prethickened formula if you aren’t breastfeeding and your baby has gastro-oesphageal reflux. You should use prethickened formula or thickeners only in consultation with your doctor.

Homemade baby formula
Homemade baby ‘formula’ that uses bone broth and other ingredients, and formula that uses ‘raw’ milk, aren’t suitable alternatives to breastmilk or shop-bought cow’s milk-based baby formula. Homemade baby formula can contain many ingredients that aren’t safe for your baby and generally won’t have the essential nutrients that your baby needs.

Changing baby formula

Once you’ve settled on a baby formula for your baby, it’s better not to change formula too often. The taste will vary slightly and it might upset your baby’s feeding routine.

If you do decide to change baby formula, read the directions on the new formula label carefully. Different formulas have different-sized scoops and are made up in different ways.

Toddler formulas

Your baby doesn’t need formula after 12 months. This includes toddler or stage 3 formulas, which are marketed at children older than 12 months.